针刀治疗腰椎间盘突出症的临床研究*

江苏闽 王翔 丁立 张继伟 王骞琛 陈东煜**

（上海中医药大学附属曙光医院石氏伤科医学中心，上海市中医药研究院骨伤科研究所 上海 201203）

摘 要目的：观察并验证针刀治疗腰椎间盘突出症的临床疗效。方法：选取2013年9月至2014年7月骨伤科门诊收治的腰椎间盘突出症患者65例，随机分为针刀组33例和臭氧组32例。针刀组采用针刀治疗，臭氧组采用臭氧注射治疗，均治疗1次。采用视觉模拟评分法（VAS）和Oswestry功能障碍指数（ODI）量表作为疗效评价指标，比较两组治疗后7 d、28 d、3个月和6个月的疗效。结果：与治疗前相比，针刀组治疗后7 d、28 d、3个月、6个月的VAS值和ODI评分均明显降低（P<0.05）；疼痛和功能障碍明显缓解，总有效率分别为87.88%和90.91%，与臭氧组疗效相当（P<0.05）。结论：针刀治疗腰椎间盘突出症具有明显的临床疗效，与臭氧消融术疗效相当。

关键词腰椎间盘突出症 臭氧消融术 针刀

*基金项目：2013年上海市科学技术委员会科研计划项目（13401903500）

Clinical study on the treatment of patients with lumbar disc herniation by acupotomy

JIANG Sumin, WANG Xiang, DING Li, ZHANG Jiwei, WANG Qianchen, CHEN Dongyu

（Shi's Center of Orthopaedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Institute of Orthopaedics and Traumatology, Shanghai Academy of TCM, Shanghai 201203, China）

ABSTRACTObjective: To observe and verify the clinical efficacy of acupotomy in the treatment of patients with lumbar disc herniation(LDH). Methods: Sixty-five outpatients with LDH treated in department of bone traumatology were enrolled from September 2013 to July 2014, and randomly divided into an acupotomy group of 33 patients and an ozone group of 32 patients. The patients received acupotomy therapy in the acupotomy group and ozone ablation therapy in the ozone group for once. The efficacy of the treatment after 7 d, 28 d, 3 month and 6 month were compared between two groups and evaluated by visual analogue scale(VAS) and Oswestry disability index(ODI) scale. Results: The VAS values and ODI scores in acupotomy group at 7 d, 28 d, 3 month and 6 month after therapy were significantly lower than those before treatment and with statistically difference (P<0.05). The pain and the body function in patients of acupotomy group were significantly relieved with total effective rates of 87.88% and 90.91%，respectively. There was no difference in clinical efficacy between two groups (P>0.05). Conclusion: Acupotomy used in the treatment of patients with LDH has significant clinical efficacy, and the results were similar to those of the oxygen-ozone therapy.

KEY WORDSlumbar disc herniation; oxygen-ozone therapy; acupotomy

腰椎间盘突出症(lumbar disc heniation，LDH)主要表现为腰痛和下肢坐骨神经放射痛，约1/5患者的腰腿痛由腰椎间盘突出所致，每年LDH的发病率高达1%～ 2%[1]，好发于20～40岁青壮年，男性多于女性。LDH可导致患者行动受限、劳动能力丧失及残障，是重要的社会问题[2]。

在LDH的微创治疗中，经皮穿刺臭氧消融术是成熟、有效的微创手术方式[3-4]，能使突出的髓核缩小而减少神经根压迫，具有显著的抗炎镇痛强氧化作用[2]，应用广泛。针刀疗法属非手术治疗，是中医学科里的新兴子学科，具有疗程短、疗效确切以及不受患者性别、年龄、中医

证型、突出部位和病程影响的优点。本研究观察并验证针刀治疗LDH的临床疗效，并与臭氧消融术比较，探讨针刀治疗的优势，以求能推广实施。……